Satisfaction with Home Healthcare Provider Service in Adults with Type 1 Diabetes Using a Hybrid Closed Loop System: The SATURN Study

Abstract

Introduction: Hybrid closed loop (HCL) systems have the potential to improve glycaemic control in people with Type 1 diabetes (T1D). In France, patient technical education and assistance for HCL users is provided by trained nurses from home healthcare providers (HHP). The objective of this study was to evaluate satisfaction of people with T1D with HHP services. Methods: In total, 35 participants with T1D and a prescription for an HCL system were studied during 3 months after HCL initiation in two French hospitals. A series of questionnaires were completed by participants. The number of planned (per protocol) and unplanned HHP interactions was monitored. Glycaemic control at inclusion and Day 90 was compared; formal statistical testing was carried out post-hoc. Results: Client Satisfaction Questionnaire (CSQ-8) with HHP service was high both at Day 30 (mean CSQ-8 score: 28.9; 95% confidence interval [CI]: 28.0; 29.9) and at Day 90 (29.0; 95% CI: 27.9; 30.0). Hypoglycemia Fear Survey-II (HFS-II) score (standard deviation) decreased from 31.2 (±15.7) at inclusion to 23.1 (±16.8) at Day 90. Participants had a median number of four home visits and two phone calls, but important differences were observed between participants: total interactions with HHP nurses ranged between five and 12 contacts, and 45.7% of participants requested unplanned interactions. Glycaemic control improved significantly: mean time in range increased from 57.0% (±13.3) at inclusion to 71.4% (±9.4) at Day 90 (p<0.001). Conclusion: HHP services for early phase HCL implementation were met with high client satisfaction levels. Study results emphasise the need for a personalised HHP approach.